| NPI | 1528204831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25386) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1138188) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2015-03-06 |